Evolving Clinical Picture of Renal Cell Carcinoma: A Population-Based Study from Helsinki.
Aged
Antineoplastic Agents
/ administration & dosage
Biopsy, Needle
Carcinoma, Renal Cell
/ diagnostic imaging
Combined Modality Therapy
Comorbidity
Cysts
/ pathology
Female
Finland
/ epidemiology
Frail Elderly
Frailty
Humans
Incidental Findings
Kidney
/ pathology
Kidney Diseases, Cystic
/ diagnostic imaging
Kidney Neoplasms
/ diagnostic imaging
Male
Middle Aged
Neoplasm Metastasis
Nephrectomy
Outpatients
Urban Population
Kidney neoplasms
Observation
Population-based
Renal cell carcinoma
Renal tumor
Surveillance
Journal
Urologia internationalis
ISSN: 1423-0399
Titre abrégé: Urol Int
Pays: Switzerland
ID NLM: 0417373
Informations de publication
Date de publication:
2019
2019
Historique:
received:
21
08
2018
accepted:
05
10
2018
pubmed:
14
1
2019
medline:
29
1
2020
entrez:
14
1
2019
Statut:
ppublish
Résumé
There is a lack of detailed population-based data for renal cell carcinoma (RCC). The study aimed to examine the contemporary changes in the clinical picture and treatment of RCC. A total of 1,719 consecutive patients living in the Helsinki metropolitan area with a solid or cystic renal mass (Bosniak 3-4) ≥10 mm were identified. Data from medical records was evaluated for clinical characteristics and treatments in the periods I (2006-2008), II (2009-2011), III (2012-2014), and IV (2015-2016). The proportions of patients with comorbidities (Charlson index ≥2) and frailty (Eastern Co-operative Oncology Group classification ≥2) increased significantly during the study period. The percentage of clinical stage I patients, cystic tumors and use of needle biopsies increased significantly. Use of observation increased from 9% (I) to 32% (IV; p < 0.001). First-line oncological treatments within 6 months were given to 47% of 262 patients with metastases and -cytoreductive nephrectomy (CN) was delivered to 54% of those patients. The size of renal tumors continued to decrease, while the percentage of patients with significant comorbidity or frailty increased. Active surveillance emerged as the initial strategy. Tyrosine kinase inhibitors with CN remained the primary option in patients with metastatic RCC.
Sections du résumé
BACKGROUND
BACKGROUND
There is a lack of detailed population-based data for renal cell carcinoma (RCC).
OBJECTIVES
OBJECTIVE
The study aimed to examine the contemporary changes in the clinical picture and treatment of RCC.
METHODS
METHODS
A total of 1,719 consecutive patients living in the Helsinki metropolitan area with a solid or cystic renal mass (Bosniak 3-4) ≥10 mm were identified. Data from medical records was evaluated for clinical characteristics and treatments in the periods I (2006-2008), II (2009-2011), III (2012-2014), and IV (2015-2016).
RESULTS
RESULTS
The proportions of patients with comorbidities (Charlson index ≥2) and frailty (Eastern Co-operative Oncology Group classification ≥2) increased significantly during the study period. The percentage of clinical stage I patients, cystic tumors and use of needle biopsies increased significantly. Use of observation increased from 9% (I) to 32% (IV; p < 0.001). First-line oncological treatments within 6 months were given to 47% of 262 patients with metastases and -cytoreductive nephrectomy (CN) was delivered to 54% of those patients.
CONCLUSIONS
CONCLUSIONS
The size of renal tumors continued to decrease, while the percentage of patients with significant comorbidity or frailty increased. Active surveillance emerged as the initial strategy. Tyrosine kinase inhibitors with CN remained the primary option in patients with metastatic RCC.
Identifiants
pubmed: 30636255
pii: 000494363
doi: 10.1159/000494363
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
390-398Informations de copyright
© 2019 S. Karger AG, Basel.